The efficacy of anti-cancer therapies depends on the genomic composition of the tumor, its microenvironment, spatial organization, and intra-tumor heterogeneity. B cell lymphomas are a heterogeneous group of tumors emerging from B cells at different stages of differentiation and exhibiting tumor-specific interactions with the tumor microenvironment. Thus, to measure response to therapy in lymphoma, it is critical to preserve the tumor composition and functional interactions among immune cells. Here, we developed a platform to maintain small fragments of human lymphoma tissue in culture for several days, and use them to test response to therapies. We collected 25 patient samples representative of different lymphoma subtypes, and established ex vivo tissue fragments that retained histological, cellular, and molecular characteristics of the original tissue, here referred to as lymphomoids. Using lymphomoids, we tested sensitivity to several clinically approved small molecule inhibitors in parallel and examined tissue remodeling upon treatment. Importantly, when this information was available, we showed that sensitivity to therapy observed in lymphomoids was consistent with patient's response in the clinic. Lymphomoids are an innovative tool to assess treatment efficacy in clinically relevant contexts and could be used to uncover novel aspects of lymphoma biology.